In September of 2010, President Obama signed a Presidential Policy Directive on Global Development. The directive was designed to define a U.S. commitment to diplomacy and international relations. The establishment of the directive was followed by a response from the Department of State and the U.S. Agency for International Development (USAID). The organizations identified global health as one of the six imperative areas to be tackled in addressing foreign relations during the current administration. These programs collectively created the platform for the Global Health Initiative (GHI). The GHI is a 5.7 billion dollar foreign aid program; a six year commitment to improving health care in 73 different countries. The initiative places a special emphasis on HIV/AIDS; TB; malaria; maternal, newborn, and child health; family planning and reproductive health; and nutrition.

Programs such as the aforementioned exemplify one of the cores of American values: recognition of disparities within communities near and far, and a commitment to improving conditions when fiscally possible. However, the concern at hand is how the U.S. will maintain these commitments with a health care burden of our own. How vastly will the financial demands of the repair of our own fragmented system, affect our pledge to international health?

Concerns about the future of international health care only echo sentiments that have been shared for decades about the general role of the U.S. in foreign affairs. With so many domestic concerns how do we justify our assistance to other countries? The response is not a simple one but it requires a thorough examination of the history that defines this country.

In the fabric of American culture lies the combined effort of individuals of all ethnicities and religions. One could argue that the economic and political success that embodies the U.S. is largely a result of the continuous migration of tenacious and perseverant individuals from all over the world seeking better opportunities for themselves and their offspring. In response to the foundation our country’s legacy has been built on, there is a social responsibility to pay it forward. There is an obligation to continue to invest in other countries all that was essentially invested in the U.S.

In the face of the repair, development, and growth of our evolving health care system, the U.S. indefinitely faces foreseen and unforeseen financial obstacles. However, there are international health devastations that often surpass those of the U.S. Only time will reveal America’s ability to allocate billions of dollars in aid to international health care initiatives such as the GHI. Yet until clear limitations are identified, the U.S. has a responsibility to continue to battle inequalities in health care whether on domestic or foreign land.